| NPI | 1992043509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKEY PICKLER Authorized Official 850-523-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |